Image guidance and stabilization for stereotactic ablative body radiation therapy (SABR) treatment of primary kidney cancer Academic Article uri icon

abstract

  • Stereotactic ablative body radiation therapy for primary kidney cancer treatment relies on motion management that can quantify both the trajectory of kidney motion and stabilize the patient. A prospective ethics-approved clinical trial of stereotactic treatment to primary kidney targets was conducted at our institution. Our aim was to report on specific kidney tumor motion and the inter- and intrafraction motion as seen on treatment.Patients with tumor size <5 cm received a dose of 26 Gy in 1 fraction and those with tumor size ≥5 cm received 42 Gy in 3 fractions. All patients underwent a 4-dimensional computed tomography planning scan, immobilized in a dual-vacuum system. A conventional linear accelerator cone beam computed tomography scan was used for pre-, mid-, and posttreatment imaging to verify target position.Between July 2012 and October 2014, 33 targets from 32 consecutive patients (24 males/8 females) were treated. Seventeen targets were prescribed 26 Gy/1 fraction and the remaining 16 targets received 42 Gy/3 fractions. Kidney motion at each of the poles was not affected by the presence of tumor (P = .875), nor was the motion statistically different from the corresponding contralateral kidney pole (P = .909). The mean 3-dimensional displacement of the target at mid- and posttreatment was 1.3 mm (standard deviation ± 1.6) and 1.0 mm (standard deviation ± 1.3), respectively. The maximum displacement in any direction for 95% of the fractions at mid- and posttreatment was ≤3 mm.In summary, stereotactic ablative body radiation therapy of primary kidney targets can be accurately delivered on a conventional linear accelerator with protocol that has minimal intrafractional target motion.

authors

  • Pham, D
  • Kron, T
  • Bressel, M
  • Foroudi, F
  • Hardcastle, N
  • Schneider, M
  • Soteriou, S
  • Innes, J
  • Siva, S

publication date

  • 2015

has subject area